Great discussion from some of South Carolina’s leaders about health care disparities and health equity in our state.  Our CEO of Palmetto Care Connections, Kathy Schwarting was part of this group.

Source SCETV

Once broadband is expanded into more low-income areas, many families will need help paying for monthly internet services.

Source WLTX Channel 19

Governor Henry McMaster discusses new education funding. The new funding is meant to help respond to immediate problems related to the coronavirus and to help with economic recovery. By Joshua Boucher

When the COVID-19 pandemic reached the small, rural town of Kingstree, South Carolina, Sandra Epps watched her tight-knit community grapple with the devastating disease. Before long, several of her own friends had lost their lives to the virus.

“It was heartbreaking,” Epps said. “It just impacts you in a lot of ways.”

Epps decided to get tested for COVID-19 after realizing she had mild symptoms. She was tested through the Medical University of South Carolina and was contacted immediately about her positive result. Along with the information about her test result, Epps was given the option to be monitored remotely by nurses located at MUSC.

Remote patient monitoring is a virtual care program that allows patients to be monitored through telehealth, while they stay in the comfort of their own home. By logging on to her patient portal, MyChart, Epps could answer questions about her symptoms. Nurses would contact her by phone or email to check in, give advice, and provide reassurance. Epps said the monitoring program made her “feel safe.”

“I was reassured and I wasn’t as frightened,” Epps said.

The novel coronavirus pandemic, which has killed more than 7,800 people in South Carolina, led many healthcare systems to adopt remote patient-monitoring models in an effort to keep hospitals from being overwhelmed.

For patients, remote patient-monitoring allows nurses to monitor symptoms closely and react quickly if needed, according to Dr. Marty Player, Associate Professor of Family Medicine and Co-director of Primary Care, Telemedicine at MUSC.

“We’re keeping contact and accountability with our patients in a much more timely way,” Dr. Player said.

Knowing that a caregiver is accessible has eased patients’ anxiety, he added.

Many of the patients who have been monitored remotely have said the virtual program prevented them from visiting the Emergency Department or an Urgent Care, according to David Wheeler, telehealth patient and provider experience coordinator at the MUSC Center for Telehealth.

“They were able to get through any kind of crisis or spike (in their illness),” Wheeler said. We were able to shepherd them through that.”

In November the Centers for Medicare and Medicaid Services (CMS) released its 2020 Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Final Rule. CMS states that its goal with the rule was to reduce federal regulatory barriers, support flexibility and promote transparency and innovation when states develop and implement managed care programs for Medicaid and CHIP.   The rule addresses telehealth specifically in relation to how telehealth visits should be counted towards meeting a managed care plan’s network adequacy requirement.  CMS states in the rule the following:

We defer to each state to determine the criteria to be applied to telehealth providers and how such providers would be taken into account when evaluating network adequacy of the state’s Medicaid managed care plans. Section 438.68(b) does not set criteria of this nature that states must use. Under § 438.68(c)(1)(ix), states must consider the availability and use of telemedicine when developing their network adequacy standards. If states elect to include telehealth providers in their network adequacy analysis, we believe that the states will establish criteria that appropriately reflect the unique nature of telehealth, as well as the availability and practical usage of telehealth in their state.

CMS also states in its press release on the rule that the adjustments it made to the minimum standards states must use in developing network adequacy requirements will support state facilitation for telehealth options.  Specifically, the rule removes the requirement for states to set time and distance standards and adds a more flexible requirement that states set a quantitative network adequacy standard for network adequacy.  It also broadens its definition of provider types, and allows states to have authority to define a ‘specialist’.  They do note however that they expect states to apply network adequacy standards to all providers types and specialties necessary to ensure that all services covered under the contract are available and accessible to all enrollees in a timely manner.  For more information on the final rule, see CMS’ factsheet or read the rule in its entirety.

CCHP Animated Video on Telehealth Reimbursement Basics
CCHP knows that telehealth policy is complicated, especially when it comes to the way that reimbursement works in the United States.  To help, we’ve developed an animated video to help those new to telehealth policy understand how telehealth policy works in the US, and the role of telehealth COVID-19 waiver and exceptions during the public health emergency.  If you want a crash course in telehealth reimbursement policy in just 13 minutes, this is the place to start!  See the video HERE.

With the novel coronavirus continuing to proliferate around the world, more and more people are suffering from a different kind of pandemic: mental health and substance abuse disorders.

In response, the South Carolina Department of Mental Health teamed up with the Department of Alcohol and Other Drug Abuse Services to create 844-SC-HOPES, an anonymous 24/7 support line for those who are struggling to cope with the numerous hardships created by the COVID-19 pandemic. In addition to mental health and addictions support, the hotline was also designed specifically to help healthcare workers and those suffering financial hardships.

Deborah Blalock, deputy director of the DMH, said when people began to practice social distancing in early March, some were disconnected from their support groups, which sometimes results in a relapse.

“If people are isolated, if people can’t reach their support groups, then they’re going to perhaps drink or use other substances,” Blalock said. “We knew that for the mental health population, that being isolated may increase depression.”

Many people are facing increased anxiety over their own personal health, job security, and the wellbeing of their loved ones, Blalock said.

In a matter of weeks, the new support line was set up in collaboration with local providers and licensed mental health and substance abuse counselors. A healthcare outreach team was created to serve healthcare workers who are struggling with the stressors caused by battling the virus firsthand.

The SCDMH provides care regardless of a person’s ability to pay but people do receive a bill. Blalock said a grant covers the costs of services.

Sara Goldsby, director of the DAODAS, said in addition to the SC Hopes hotline, many of the traditional services provided by the DMH and the DAODAS have been moved online, so that people do not miss out on support, as they practice social distancing.

“People don’t need to feel disconnected and isolated,” Goldsby said. “All of the treatment services that folks would typically receive at our county alcohol and drug authorities are available by telehealth and by telephone; and this main support line that’s accessible to any South Carolinian is that connection to those services. We really want people to be reaching out to connect.”

Traditionally a supplementary and underutilized form of health care delivery, telehealth is now one of the frontline pillars of defense against the COVID-19 pandemic. In April 2020, a Morning Consult poll found that 23% of adults have used telemedicine services since the outbreak of COVID-19, and virtual visits surged 50% in March 2020, compared to February. By keeping patients away from busy hospitals, telehealth is helping to reduce the burden on overwhelmed care centers and the risk of infections. However, the potential applications of telehealth extend far beyond this crisis. It could help ease longstanding problems with health care costs and accessibility, particularly in underserved communities.  Today, New Center policy analyst Olive Morris checks in with Mei Kwong with the Center for Connected Health Policy to explore the potential of telehealth during and after the crisis.